The Challenge in Burden of Pulmonary Arterial Hypertension: A Perspective From the Global Burden of Disease Study

Figures

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  FIGURE 1. DALYs and deaths shifts across age and sex difference. (A) The female/male proportion of DALYs number among different age groups including 0–14 years, 15–49 years, 50–69 years, and more than 70 years groups from 1990 to 2021. (B) The female/male proportion of death number among different age groups including 0–14 years, 15–49 years, 50–69 years, and more than 70 years groups from 1990 to 2021. Abbreviations: DALYs, disability‐adjusted life years; SDI, socio‐demographic index.

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  FIGURE 2. The trends of pediatric PAH by age and SDI group. (A) The number of DALYs, deaths, and prevalence in 1990 and 2021 among different age groups, including the less than 12 months, 12–23 months, 2–4 years, 5–9 years, 10–14 years, and 15–19 years age groups. (B) The rates of DALYs, deaths, and prevalence in 1990 and 2021 among different age groups, including the less than 12 months, 12–23 months, 2–4 years, 5–9 years, 10–14 years, and 15–19 years age groups. The dotted line represents the 50% confidence interval. Abbreviations: DALYs, disability‐adjusted life years; PAH, pulmonary arterial hypertension; SDI, socio‐demographic index.

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  FIGURE 3. Associations of the SDI (A) and UHCI (B) with age‐standardized rates of DALYs, deaths, and prevalence from PAH in 2021. Pearson's correlation test was used to evaluate the associations between the SDI and UHCI and age‐standardized rates. Abbreviations: PAH, pulmonary arterial hypertension; SDI, socio‐demographic index; UHCI, universal health coverage index; CIs, confidence intervals.

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  FIGURE 4. Age‐period‐cohort models of PAH DALYs in global and five SDI quantiles. (A) Age effects show the fitted longitudinal age curves of PAH DALYs rate (per 100,000 person‐years) and the corresponding 95% CIs. (B) Period effects show the relative risk of PAH DALYs rate of each period compared with the reference (period 1992–1996) adjusted for age and nonlinear cohort effects and the corresponding 95% CIs. (C) Cohort effects show the relative risk of PAH DALYs rate of each cohort compared with the reference (cohort 1921–1929) adjusted for age and nonlinear period effects and the corresponding 95% CIs. Abbreviations: PAH, pulmonary arterial hypertension; DALYs, disability‐adjusted life years; SDI, socio‐demographic index; CIs, confidence intervals.

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  FIGURE 5. Exemplar countries across different regions and SDI quantiles showing unfavorable age‐period‐cohort effects in PAH DALYs. Ten countries or regions including (A) two high‐SDI regions [Taiwan (Province of China) and the United States of America], (B) two high‐middle‐SDI countries (Greece and Libya), (C) two middle‐SDI countries (Algeria and Tunisia), (D) two low‐middle‐SDI countries (Pakistan and Sudan), and (E) two low‐SDI countries (Yemen and Zimbabwe) were selected, which presented the unsatisfactory APC effects in DALYs. Overall trends in the DALYs rate from 1990 to 2021. The fitted longitudinal age curves display the DALYs rate of PAH per 100,000 person‐years, along with the corresponding 95% CIs. Period effects illustrate the relative risk of PAH DALYs for each period, compared with the reference period of 1992–1996, adjusted for age and nonlinear cohort effects, and include the corresponding 95% CIs. Cohort effects show the relative risk of PAH DALYs for each cohort, using the 1921–1929 cohort as the reference, adjusted for age and nonlinear period effects, with the corresponding 95% CIs provided. Abbreviations: PAH, pulmonary arterial hypertension; DALYs,…